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Thread: Med Questions?

  1. #1
    Join Date
    Jun 2007
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    Default Med Questions?

    Hi All,

    Regarding Methotrexate. Since I was diagnosed in February with SLE-my Discoid went inwards so to speak, I was given methotrexate. The drug has helped my numbers but at a significant cost, i.e. weight loss, fatigue, anemia, malaise, minor depression etc.

    What dosages have been usually prescribed for SLE? Are the dosages ever increased? Tolerances developed etc? What side effects has anyone experienced with methotrexate? Anyone ever gone into quick remission as a result of this med?

    I have been on this since early April at 10 mgs. per week in addition to Plaquenil and the effects are quite debillitating, i.e. fatigue, nausea, abdominal cramps. My doctor recommended increasing the dose but due to the fact that I will be able to stay away from working in a stressful environment for the next 30 days there is no need for a dose increase.

    Any info will greatly help. Kind of having a rough day today and can't put my finger on it.

    Thanks to any and all for being here.

  2. #2
    Join Date
    Nov 2001
    Victorville, California
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    Thanked 1,128 Times in 743 Posts


    Hi Juanerd :lol:
    The immunosuppressive drugs, Methotrexate (Rheumatrex) or azathioprine (Imuran) are used as steroid-sparing drugs. Sometimes, if a patient is using prednisone, Medrol, or solu-medrol to help control their lupus, and they begin to have complications, their doctor may start them on Methotrexate.
    The dosage of methotrexate depends upon your symptoms and the extent of your organ involvement. Doctors generally will prescribe low dosages of Methotrexate (Rheumatrex), such as 7.5 to 10 mgs, given orally once per week, and these dosages have been extremely effective in the treatment of lupus. The dose may be increased as needed up to 20-25 mg/week. Results are usually seen about 3 to 6 weeks after treatment with methotrexate. It may take 12+ weeks for some patients to realize the full benefit of methotrexate treatment.

    As you know, Plaquenil can also take quite some time before you will really feel its effects. Once you do, you may notice an improvement with your fatigue (especially with the methotrexate).

    Side Effects of Methotrexate: Methotrexate has rarely caused serious (sometimes fatal) side effects. Methotrexate can be well tolerated, but also can cause severe toxicity which is usually related to the dose taken. The most frequent reactions include mouth sores, stomach upset, and low white blood counts. Methotrexate can cause severe toxicity of the liver and bone marrow, which require regular monitoring with blood testing. It can cause headache and drowsiness, which may resolve if the dose is lowered. Methotrexate can cause itching, skin rash, dizziness, and hair loss. A dry, non-productive cough can be a result of a rare lung toxicity.

    Lupus remission is just as unpredictable as the disease itself. There are a lot of drug companies who will claim that their drug can help you to acheive remission, but I would not place all of my faith in the use of any one drug. Regular care, appropriate lifestyle changes, taking medications as ordered, being pro-active in your health care are all ways that you can help yourself to get closer to remission!

    Peace and Blessings

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